新生儿重症监护病房医院感染的目标性监测与控制  

Targeted Surveillance and Control of Nosocomial Infection in Neonatal Intensive Care Unit

作　　者：时萍[1] 姚文[1] 曹志红[1] 冷萍[1] 

机构地区：[1]山东青岛大学医学院附属医院药学部,山东青岛266003

出　　处：《中国执业药师》2013年第12期3-5,共3页China Licensed Pharmacist

摘　　要：目的:调查新生儿重症监护病房(NICU)医院感染的发生情况,探讨新生儿医院感染的特点,评价NICU医院感染目标性监测及采取干预措施降低医院感染发生的效果。方法:对入住NICU>48 h的患儿开展医院感染的目标性监测,同时采取一系列综合措施预防控制感染,并对监测结果进行统计分析。结果:共监测病例2 201例,干预前后医院感染发病率分别是3.17%和1.28%(P<0.05);日感染发病率分别为4.11‰和2.12‰(P<0.05);呼吸机相关性肺炎(VAP)日感染发病率分别是3.32‰和5.18‰(P<0.05)。未见导管相关血流感染(CR-BSI)及导尿管相关尿路感染(CA-UTI)。感染性病原菌以产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌多见。结论:目标性监测有利于及时发现NICU医院感染的危险因素,便于为临床提供有针对性的感染控制措施;针对危险因素采取干预措施可以有效降低医院感染的发生。Objective： To investigate the incidence ofnosocomial infection in neonatal intensive care unit （NICU）, to explore its characteristics and to evaluate the effectiveness of targeted monitoring and intervention measures in the preven- tion of nosocomial infection. Methods： Targeted surveillance was carried out for the neonates enrolled in NICU over 48 hours, at the same time a series of measures were taken for the prevention and control of infection and the surveillance re- suits were analyzed. Results： Among 2 201 monitoring cases the nosocomial infection rate before and after the intervention was 3.17% and 1.28% （P 〈0.05） respectively, the daily infection rate was 4.11%o and 2.12%（P 〈 0.05）, and the inci- dence of ventilator-associated pneumonia （VAP） per patient day was 3.32% and 5.18%o（P 〈 0.05 ）. There was no catheter related blood stream infection （CR-BSI） and catheter-associated urinary tract infection （CA-UTI）. The main pathogens were extended spectrum beta-lactamases （ESBLs）-producing Klebsiella pneumoniae subs. pneumoniae. Conclusion： Tar- geted surveillance was helpful to discover the risk factors of the nosocomial infection in NICU and to provide effective con- trol measures for clinical application. Prevention measures against various risk factors can effectively reduce the incidence of nosocomial infection.

关 键 词：新生儿重症监护病房 医院感染 目标性监测 干预措施 

分 类 号：R459.3[医药卫生—治疗学]